TAF Company Information Form Step 1 of 4 25% Thank you for choosing The Allen Firm, PC to help you. Our Firm values people and developing personal relationships. If we represent you in your matter, our team will strive to provide reliable and practical help to you in your matter while guided by our foundational values of honoring people, operating with integrity, and striving for excellence. Please complete the following area with your detailed contact information.Today's Date* MM slash DD slash YYYY Personal InformationName* First Last Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email Address* Best Phone Number*Date of Birth* MM slash DD slash YYYY Drivers License Number* Last 4 Digits of SS #* Employer Title Company InformationCompany Name* Company Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Area of LawPlease indicate the area of law of which the Company is interested in consulting with The Allen Firm.* Real Estate Oil & Gas Healthcare Law Family Law Employment Law Contracts Business Formation and Management Appellate Matters Administrative Law Probate & Administration Immigration Matters Litigation Estate & Trust Planning Dispute Resolution Collections Bankruptcy Agriculture Accident & Injuries Please briefly describe the matter in which you are seeking consultation.*Please check one of the following statements which best describes any concern the Company may have regarding The Allen Firm's representation of you. Expense Timeliness Regularly Informed No Concerns Outcome Other Please give us information about your decision to choose "Other".*Please list the names of all other known parties involved in the matter so that we may complete a conflict of interest check and advise you if a conflict exists.Have you consulted or retained any other attorneys on this matter before coming into our Firm?*NoYesWith whom did you consult and when? Source InformationDoes your Company utilize social media?* Facebook Twitter Linkedin Pinterest Google+ Youtube Do Not Use How have you heard about The Allen Firm? (Check all that apply)* Friend / Family Member Internet Phonebook Newspaper Social Media Radio Other I Haven't Before Today Friend / Family Members Name: Internet Site where you found us: Name of Phonebook: Name of Newspaper: Name of Social Media Site: Please tell us where you heard about us: How much do you know about The Allen Firm*Regular Client of The Allen FirmVery FamiliarKnow a Little About ThemNoneWhat information or free resources could we provide you that would help you in your business or personal legal matters?Digital Signature*